Aprotinin, known also as Trasylol by its manufacturer Bayer, is an intravenously administered medication used to reduce bleeding during complex surgical procedures, mainly in heart and liver surgeries.

The major benefit of the drug during such delicate surgeries is the slowing down of fibrinolysis the process that leads to the breakdown of blood clots. It decreases the need for blood transfusions during surgery, as well as preventing major organ damage by preventing a drop in blood pressure.

While Aprotinin was available as early as the 1960s, it did not see wide usage in its most recent capacity until it was picked up, patented, and aggressively marketed by the Bayer Corporation as Trasylol towards the end of the 1980s. It was originally used to treat acute pancreatitis where it inhibited enzymes in the pancreas. It was however, not used widely as a blood loss drug within extensive surgical procedures until the late 1960s.

Bayer began funneling serious capital into the research and development of Aprotinin as a replacement medicine for aminocaproic acid, the most commonly used anti-fibrinolytic medication given to control post-operative bleeding. Routinely, patients undergoing major surgeries involving potential blood transfusions, sustained bleeding, or large amounts of blood loss have been given aminocaproic acid, with a relatively low rate of drug-induced mortality.

In fact, the largest risk factor for patients receiving aminocaproic acid was not due directly to the drug's interaction with the patient, but rather from acute thrombosis, the formation of a clot inside a blood vessel obstructing the flow. This can have several potentially fatal results; kidney failure, heart attack, or stroke are all possible outcomes of this Trasylol side effect. However, as with any major surgery, these are calculated risks, almost precisely dialed down to an exact percentage. In many cases, the likelihood of a healthy patient fatality in major surgery is less than 5 percent. Indeed, this is due not only to the advances in medical technology, but also to the knowledge, research, and practical application of tested medicines.

However, this was untrue for Trasylol; through dubious politics, aggressive marketing, and generally questionable events surrounding it's takeover of the market, Trasylol became the medical industry standard for open heart and liver surgeries. Bayer's profits increased exponentially; sales of the drug hit $300 million in 2005, with projected sales of $750 million for 2006. It had replaced the antifibrinolytic and anti-proteolytic drugs and become the flagship drug for reducing blood loss. However, it has recently been discovered that Bayer was aware of an increased Trasylol risk of fatality, almost 64 percent higher, in patients receiving Trasylol during surgery.

While several studies have recently come out showing the dangers of Trasylol and it's tendency to induce both acute renal (kidney) failure, heart attack, stroke, and death, this is not new knowledge to the Bayer corporation.

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